[Diagnosis and surgical treatment of thoracolumbar vertebral Chance fractures caused by a fall].
OBJECTIVE
To explore the diagnosis of Chance fractures of thoracolumbar spine and the clinical efficacy of segmental pedicle screw instrumentation in the treatment.


METHODS
The clinical data of 16 patients with Chance fractures from January 2000 to January 2007 were retrospectively analyzed. All patients were treated with segmental pedicle screw instrumentation. Radiology and the Oswestry Disability Index (ODI) were used to evaluate the efficacy.


RESULTS
One case associated with open dislocation of ankle and craniocerebral injury, 3 cases with calcaneus fracture and 1 with kidney contusion. All cases were followed up from 7 months to 6 years, with a mean of 2.6 years. There were no operation complications. The anterior vertebral body height of fracture vertebra was restored from preoperative (63.3 +/- 6.8)% to postoperative (92.1 +/- 4.0)%, at the follow-up (90.7 +/- 3.6)%. There was a significant improvement between preoperative and postoperative values (P < 0.01) and no difference between initial postoperative and final follow-up (P > 0.05). The mean ODI was 4.9.


CONCLUSIONS
The injuries associated with Chance fracture caused by a fall and its mechanism are different from those with the safety belt injury. The segmental pedicle screw instrumentation can rebuild spinal stabilization and restore spinal alignment in treatment of Chance fractures.
Wang
Gen-lin
GL
Department of Orthopaedic Surgery, First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Yang
Hui-Lin
HL
Cai
Xin
X
Shi
Jin-Hui
JH
Tang
Tian-Si
TS
D000328:Adult; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries*; D016896:Treatment Outcome